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To the Editor: Drs Glover and Maron¹ fail to include some important information that could affect their conclusions and recommendations. Currently, the preparticipation physical examination (PPE) has become the standard of care for athletes of all ages as they prepare for athletic participation. These assessments are intended to identify medical and orthopedic conditions that may affect safe and effective athletic participation.²

While the effectiveness of the PPE in detecting physical abnormalities serious enough to limit athletic participation has been demonstrated, the PPE may not predict or help prevent many athletic injuries.³ The medical value of these examinations has little outcomes-based evidential support. In addition, the PPE has an unfavorable cost-benefit ratio even if costs are carefully controlled.⁴ Although the high school forms were described as "abbreviated and may be inadequate," we are not aware of any studies that demonstrate that the morbidity or mortality rates from high school athletics vary . . . [Full Text of this Article]